The Impact of Social Determinants of Health on Chronic Diseases: A Narrative Review

Chronic diseases such as cardiovascular disease, diabetes, chronic respiratory disorders, and certain cancers are leading causes of morbidity and mortality worldwide. While biological and behavioral factors contribute to their development, growing evidence indicates that social determinants of health (SDOH) play a fundamental role in influencing chronic disease outcomes. SDOH include socioeconomic status, education, employment, housing conditions, neighborhood environment, access to nutritious food, and availability of healthcare services. These factors not only shape individual health behaviors but also determine access to preventive care, disease management resources, and overall quality of life. Individuals and communities facing socioeconomic disadvantage are disproportionately affected by chronic diseases due to cumulative exposure to risk-enhancing environments, chronic stress, limited health literacy, and systemic barriers within healthcare systems. This narrative review explores the multidimensional impact of SDOH on the prevalence, progression, and management of chronic diseases. It highlights the interconnected nature of social and environmental influences and examines how disparities in education, employment, housing, and racial or geographic equity contribute to poor health outcomes. The review also identifies key gaps in the existing literature, including the need for more intersectional and context-specific research, particularly in underserved and marginalized populations. Lastly, it proposes future directions that include policy integration, community engagement, and cross-sector collaboration as essential strategies for addressing the root causes of chronic disease and promoting health equity. Understanding and addressing SDOH is crucial for creating effective, sustainable, and inclusive approaches to chronic disease prevention and management.